Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid
The authors of this journal article state that sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. They say that over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. Preliminary data suggests that the combination of Hydrocortisone, Ascorbic Acid and Thiamine (HAT therapy) may reduce organ failure and mortality in patients with sepsis and septic shock. HAT therapy is based on the concept that a combination of readily available, safe and cheap agents, which target multiple components of the host's response to an infectious agent, will synergistically restore the dysregulated immune response and thereby prevent organ failure and death. This paper reviews the rationale for HAT therapy with a focus on vitamin C.
ConclusionAdding levosimendan to standard care in septic shock was not associated with less severe organ dysfunction nor lower mortality in patients with biochemical evidence of cardiac dysfunction.
Conclusions: There is significant increase in intraocular pressure due to prone positioning among acute respiratory distress syndrome patients. Intraocular pressure increases as early as 10 minutes after proning, with increasing trend during prone position, which persisted even at 30 minutes after the end of post prone session although with decreasing trend.
A peripheral perfusion-targeted resuscitation during early septic shock has shown encouraging results. Capillary refill time, which has a prognostic value, was used. Adding accuracy and predictability on capil...
Condition: Shock, Septic Interventions: Drug: nangibotide low dose; Drug: nangibotide high dose; Drug: placebo Sponsor: Inotrem Not yet recruiting
Editor ’s PerspectiveWhat We Already Know about This TopicAmong patients with sepsis or septic shock, a variety of extracorporeal blood purification techniques are availableIndividual existing trials evaluating these options are underpowered to provide clear evidenceWhat This Article Tells Us That Is NewMeta-analysis of very low-quality randomized controlled trial evidence demonstrates a potential benefit of hemoperfusion, hemofiltration, or plasmapheresisAdditional high-quality trials demonstrating benefit in modern clinical practice are needed before recommending these therapiesBackground Sepsis and septic shock ar...
Conclusions Ultrasound enables identification of specific early diaphragm atrophy that affects the majority of mechanically ventilated patients and septic shock patients. Diaphragm atrophy and pectoral muscle atrophy seem to be two unrelated processes.
AbstractBackgroundFluid infusion represents one of the cornerstones of resuscitation therapies in order to increase oxygen delivery during septic shock. Fluid overload as a consequence of excessive fluid administration seems to be linked to worse long-term outcome. However, its immediate effect on patient ’s clinical state is poorly described. The goal of this study was to assess the impact of FO on SOFA score kinetics as a surrogate marker of organ dysfunction from day 0 to day 5.Material and methodsRetrospective, multicenter, investigator-initiated study. All adult patients (> 18 years old) admitt...